Apply for Assistance

Please submit inquiries here

Please be aware that DV LEAP assists with legal appeals of unjust rulings in domestic violence and child abuse cases. We do not provide legal representation for individuals before there is a judgment. Residents of the District of Columbia, Maryland and Virginia may be eligible for certain limited additional assistance.

Please fill out the form below so we can assess your eligibility. If you are seeking help in an appeal, we will also need to review the written court transcripts to determine if your case meets the necessary criteria. Please note that sending us information does not create an attorney-client relationship and we cannot guarantee we will be able to help you.


Name: *



State/County where case is being litigated:

Email: * please make sure your email is correct

Your Phone:

Attorney (if represented):

Attorney's Firm:

Attorney's Office Phone:

Attorney's Email:

How did you find out about DV LEAP?

Opposing Party (full name):

Opposing Counsel:

Issue(s) you would like assistance with (brief description): *

Specific assistance you think DV LEAP can provide you:

In order to better serve our clients and expand our reach to survivors, DV LEAP asks the following two questions about income and race/ethnicity. This demographic information is confidential and will NOT affect your eligibility for an appeal.

Please select the average number of people living in your household over the past 12 months, and indicate whether your annual gross (before taxes) income was above or below the corresponding amount listed below *

What is your race/ethnicity? *

Has there been a final court order in your case? If yes, what was the date?

Are there any upcoming legal deadlines?

Thank you! Your submission has been received!

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